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Table 1 Laboratory and imaging tests performed after development of acral ischemia

From: Acral vascular necrosis associated with immune-check point inhibitors: case report with literature review

  Tests Performed Results
Infection CBC, CRP
Blood cultures
Echocardiography
HBV, HCV
Normal
Negative
No vegetation or myxoma
Negative
Hypercoagulable state Protein C
Protein S
Anti- thrombin 3
Platelet
PT/aPTT/INT
131% (Normal)
73% (Normal)
Normal
280 10 × 3/uL (Normal)
Normal
Lymphoproliferative disease Kappa/Lambda Ratio
Beta-2 microglobulin (B2M)
LDH
SPEP/IFE
1.37 (Normal)
3 mg/L (Mildly elevated)
138 U/L (Normal)
Normal
Tumor invasion CT Chest
CT Angiography
No invasion of sympathetic nervous plexus
No vascular occlusion, saccular aneurysm or stenosis up to the palmar arch arteries
Autoimmune and inflammatory disease / Thromboangiitis obliterans ANA
ESR
CH50
ANCA-c, ANCA-p
Cryoglobulin
APL ab, Anti-Scl-70 Ab, Anti-dsDNA ab, Anti-U1 RNP Ab, Anti-Sm ab, Anti-Ro/SSA ab
Nailfold videocapillaroscopy
Skin biopsy
1:80 Homogeneous
70 mm/hr
170 CAE Units (elevated)
(Acute phase reactant)
Normal
Negative (Normal)
Not performed
Not performed
Not performed
  1. Ab: antibodies, APL: antiphospholipid, Anti-Scl-70: topoisomerase I, ANCA-c: Central anti-neutrophil cytoplasmic antibodies, ANCA-p: perinuclear anti- neutrophil cytoplasmic antibodies, Anti-Sm: anti smith antibodies, Anti-Ro/SSA: anti sjögren’s syndrome related antigen A, SPEP: serum protein electrophoresis, IFE: immunofixation electrophoresis